State of California M E M O R A N D U M To: PERSONNEL MANAGEMENT LIAISONS Date: February 19, 1993 Reference Code: 93-16 THIS MEMORANDUM SHOULD BE DISTRIBUTED TO: Personnel Officers Personnel Services Supervisors From: Department of Personnel Administration Subject: GROUP LEGAL SERVICES PLAN OPEN ENROLLMENT The Department of Personnel Administration is implementing a new benefit for State employees. This benefit is a voluntary, employee-paid Group Legal Services Plan provided by Midwest Legal Services (MLS). The Plan will provide eligible employees and their family members with access to a toll-free legal hotline, preventive legal services, and a large panel of attorneys providing l00% paid-in-full coverage for the covered legal matters. The Plan provides coverage in a variety of legal areas including will preparation, consumer complaints, serious traffic matters, adoptions, real estate transactions, bankruptcy, trial defense (for civil actions, juvenile court proceeding, criminal misdemeanor charges), and domestic matters (contested and uncontested divorces, legal separations or annulments, modification of divorce decrees). Each of the covered services can be used once per family per plan year. If the employee uses an attorney who is not a member of the panel, the plan will reimburse the employee for legal fees paid up to a specified dollar limit. The monthly premium is $l0.93 for individual coverage and $l6.l9 for family coverage. The monthly premium will be automatically deducted from the enrolled employee's paycheck. If your employees have specific questions regarding the plan coverages that you are unable to answer, they should be directed to call a MLS service representative at (800) 247-4184. ELIGIBILITY All probationary and permanent employees who work on a half-time or greater time base in the following categories shall be eligible for coverage under the Plan: l. Excluded Employees with a Collective Bargaining Identification Designation (CBID) of Managerial (M), Supervisory (S), Confidential (C), and Excluded/Exempt (E97, E98, and E99). 2. Represented Employees in Bargaining Units l, 2, 3, 9, l0, ll, l8, 20, and 2l. 3. Employees on limited term, T & D, or TAU assignments who otherwise meet this criteria may enroll ONLY if they have a mandatory right of return to a position and status that also meets the criteria. Employees in permanent intermittent appointments are not eligible. ELIGIBILITY OF DEPENDENTS Eligible dependents are defined as the eligible employee's legal spouse and any unmarried, dependent children under the age of 23. Children include natural, adopted, or step-children. An unmarried child, 23 years or over is also eligible if he/she is incapable of self-support because of physical disability or mental incapacity and he/she is chiefly dependent on the eligible employee for support and maintenance. Family members who are not eligible include parents, grandparents, unmarried family partners, children under age 23 who marry and subsequently divorce, children over age 23, unless disabled as defined above and other relatives or persons not identified as eligible. OPEN ENROLLMENT PROCEDURES AND EFFECTIVE DATES Open enrollment for the Group Legal Services Plan will be conducted annually from March l through March 31. Eligible employees may voluntarily choose to participate in the plan by completing and returning an enrollment form to their Personnel Office during the enrollment period. During the initial open enrollment period, the carrier will mail an informational packet directly to the home addresses of all eligible employees. This packet includes a cover letter from DPA, a brochure which provides more detailed information regarding the plan, a condensed listing of plan attorneys in the State of California, and a blank enrollment form. New enrollees must complete the Group Legal Services Plan Enrollment Authorization Form, Sections A and B and submit it directly to their Personnel Office. Personnel Offices are responsible for verifying the employee's eligibility, completion of Section C and submission of the forms on a flow basis to the State Controller's Office (SCO). Correctly completed enrollment forms must be received by SCO no later than the l0th of each month to be effective the first of the next pay period. Incorrectly completed forms will be returned to departments for correction, thus delaying the effective date of coverage. Employees must be advised that legal coverage is effective the first of the month following the pay period in which the earnings statement on the payroll warrant shows a premium deduction. For example, coverage is effective April lst when the payroll warrant for the March pay period reflects a premium deduction. There is no retroactive effective date of enrollment. Employees who enroll in the Plan are not required to re-enroll each open enrollment in order to continue coverage. Coverage will automatically continue unless the employee submits a new authorization form specifically requesting cancellation. If an eligible employee does not enroll during open enrollment, he/she must wait until the next annual open enrollment. ENROLLMENT PROCESS FOR NEWLY ELIGIBLE EMPLOYEES Only "newly eligible" employees will be allowed to enroll in the Plan after the annual open enrollment. "Newly eligible" means employees who meet the eligibility criteria as a result of: - new appointments to State service in an eligible class, - promotions from an ineligible to an eligible class, or - changes in CBID that change an employee's status from ineligible to eligible Department personnel offices are responsible for notifying newly eligible employees of the Group Legal Services Plan and the enrollment period. A newly eligible employee has 60 calendar days from the effective date of eligibility to complete and sign a Group Legal Services Plan Enrollment Authorization Form and submit it to the Personnel Office. The transaction key-in date, PAR turnaround date, or NOPA date may be used as the beginning date for the 60-day enrollment period. Once the enrollment form has been submitted, Personnel Offices are responsible for verifying that the employee is a newly eligible, assuring that Sections A and B have been properly completed, verifying that the employee enrolled within the 60-day limitation, and for completing Section C. The eligibility period should be written in the remarks section (Section 9). Employees should be advised that coverage will become effective on the first day of the calendar month immediately following the pay period from which the first premium deduction is made. Newly eligible employees who do not enroll during their 60-day enrollment period must be advised that they will have to wait for an open enrollment period should they wish to enroll at a later date. CHANGES IN COVERAGE Employees who enroll in the plan do not have to wait until the next annual open enrollment to make changes to their level of coverage. There are various types of qualifying events which may result in the employee changing his/her coverage. For example, an employee who selects individual coverage and subsequently marries during the plan year can re- submit a form to change his/her coverage from individual to family coverage. Conversely, a single parent whose enrolled dependent child marries or an employee who divorces may elect to change his/her family coverage to individual coverage. The employee must submit an enrollment form within 60 days of the qualifying event (e.g., divorce, legal separation, marriage, child losing eligibility due to age or marriage). The employee will need to complete Section A, noting that he/she is making a change and also Section B, to identify the level of coverage that is being selected and adding or deleting any new dependents, as applicable. Personnel Offices are responsible for verifying that the employee has properly completed Sections A and B, verifying that the employee is enrolling within the 60 day limitation, for completing Section C and submitting the forms to the SCO on a timely basis. Personnel Offices are also responsible for informing the employee that the change becomes effective the first day of the month following the pay period in which the earnings statement on the payroll warrant reflects the premium change. CANCELLATION OF COVERAGE Cancellation of coverage by an enrolled employee can occur at any time. Enrolled employees are not required to remain in the plan for a minimum period of time. The employee must complete Sections A and B of the enrollment form noting that he/she is electing to cancel plan coverage. In order to receive certain covered services (e.g., divorce, bankruptcy, defense of civil actions), the employee must have been enrolled in the Plan for at least six months. If an employee cancels and subsequently re- enrolls at a later date, he/she will have to requalify in order to receive coverages with a waiting period. That is, the employee will have to remain in the plan for a new six-month period. Personnel Offices are responsible for verifying that the employee has properly completed Sections A and B, for completing Section C, and submitting the forms to the SCO on a timely basis. Personnel Offices must also advise employees cancelling plan coverage that they cannot re-enroll in the Group Legal Services Plan until the next open enrollment period. COMPLETION OF THE GROUP LEGAL SERVICES PLAN ENROLLMENT FORM A supply of the enrollment brochures and enrollment forms will be provided to each department. However, if additional supplies are needed during the year, they can be ordered by calling Midwest Legal Services at (800) 247-4184. Section A l. Employee checks type of action--new enrollment, change, or cancel 2. Employee provides social security number, name, date of birth, and mailing address. Section B 1. Employee selects type of coverage and lists name(s) and date(s) of birth of dependents if selecting family coverage; or 2. Employee elects to cancel coverage. 3. Employee signs and dates Section C l. Personnel Office completes all blank items in Section C. 2. Personnel Office verifies that employee is eligible based on CBID. 3. In item 9, "Remarks", the Personnel Office must enter the eligibility period beginning and ending dates. This information is required on all enrollment forms, with the exception of cancellation forms and open enrollment forms. All documents processed during any open enrollment period are considered open enrollment documents, and remarks are not required in Section C, item 9. CONTINUATION OF COVERAGE UPON LOSS OF ELIGIBILITY Transfer to Ineligible Class The SCO will conduct a post-audit to identify employees who lose their eligibility and their enrollment will be automatically cancelled. Retirement Employee cannot convert the Group Legal Services Plan into an individual policy. Disability Premium will be deducted from NDI/IDL check as long as the employee is on disability. Leave Without Pay Employee must contact Midwest Legal Services 30 days in advance of the leave to make arrangements for direct payment. If the anticipated leave period is one year or less, the employee must pay the full premium amount in advance. If the leave period is expected to be more than one year, the employee may arrange to make premium payments in multiple installments. Should there be an overpayment of the premium, the carrier shall refund the difference. If the employee chooses not to make direct payments, the coverage will terminate until the employee returns to work. Upon return to active pay status, the payroll deduction will start automatically and the effective date will start anew. Consequently, the employee will have to requalify for those coverages with a waiting period. Termination/Separation Employee cannot convert the Group Legal Services Plan into an individual policy. Death Plan coverage terminates. CLAIM FORMS, CERTIFICATES OF INSURANCE, LISTING OF PANEL ATTORNEYS, AND MEMBERSHIP CARDS Personnel Offices will not be responsible for providing employees with claims forms, certificates of insurances, etc. Once an employee enrolls in the plan, the carrier will mail a "fulfillment kit" directly to the employee's home address. The kit will contain the toll-free number of the legal hotline firm, a Certificate of Insurance describing the plan coverages, a detailed listing of the attorney panel in the state in which the employee is located, an identification card and a claims form. If you have any further questions regarding the Legal Services Plan or need clarification on any information provided in this memorandum, please call Vallita Lewis at (9l6) 324-9362 or ATSS 454-9362. Wendell Coon, Chief Policy Development Office